桡骨远端骨折畸形愈合临床多中心回顾性分析

Multi-center clinical retrospective analysis of distal radius fracture malunion

目的对3种治疗方法造成桡骨远端骨折畸形愈合的原因及对腕关节功能的影响进行评价。方法回顾性分析自2001年12月～2011年10月收治的桡骨远端骨折畸形愈合82例的临床资料,其中石膏固定48例,外固定架固定24例,内固定10例,分析3种治疗方法造成畸形愈合的原因及对腕关节功能的影响。结果 82例畸形愈合患者中34例为桡骨短缩,22例为关节面背倾或桡偏,15例为关节面不平整,11例为下尺桡关节脱位。桡骨远端骨折畸形愈合影响腕关节及前臂的功能,造成生活质量下降。结论不合理的固定方式是造成骨折畸形愈合的主要原因,对不同类型的桡骨远端骨折应采取不同的治疗方案,畸形愈合对腕关节造成的影响应引起足够的认识。

Objective To evaluate the cause and effect of three treatment methods for distal radius fracture malunion and influence for wrist joint function. Methods The clinical follow-up data of 82 patients with distal radius fracture malunion were retrospectively reviewed from December 2001 to October 2010,48 cases of distal radius fracture were treated by closed reduction and cast immobilization, 24 cases of distal radius fracture were treated by external fixation, 10 eases of distal radius fracture were treated by internal fixation. The cause and effect of three treatment for distal radius fracture malunion were evaluated. Results Thirty four patients with distal radius fracture malunion were radial shortening, 22 cases of distal radius fracture malunion were dorsal inclination or radial inclination,15 cases of distal radius fracture malunion were joint incongruity, 11 cases of distal radius fracture malunion were dislocation of distal radioulnar joint. The distal radius fracture malunion affected wrist joint and forearms function, and life quality. Conclusion The unreasonable immobilization is the main reason for malunion. Different distal radius fracture should be treated by the different fixation. We must pay more attention to the effect of malunion on the function of the wrist.